healthcosts.net
Insert semi-rigid prosthesis at mercy hospital
1320 Mercy Drive Northwest, Canton, OH · Cleveland Clinic · · NPI 1366433195
$2,384.20
Cash price Discounted cash price What a hospital charges a self-pay patient who pays directly, without going through insurance — usually well below the gross charge. Example: A CT scan has a $3,200 gross charge but an $850 discounted cash price. Ask for it by name when scheduling — hospitals don't always advertise it up front.
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What you pay up front if you don't use insurance.
$3,668.00
Gross charge Gross charge (chargemaster price) The hospital's full, undiscounted list price — pulled from its internal "chargemaster" price list. Almost no one actually pays this. Example: A chest X-ray has a gross charge of $1,450. The same hospital's discounted cash price for the same X-ray is $180 — the gross charge mostly anchors negotiations, not what patients pay.
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The hospital's undiscounted list price — almost no one pays this.
$1.10 with Zing Health vs $21,917.95 with MMO — same scan, same building. Share
Negotiated rates by payer
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Negotiated rate
The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.
Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.
Full explanation →
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Negotiated rate
The price a specific insurance plan agreed to pay the hospital for a service — it varies by insurer, and even by plan within the same insurer.
Example: The same knee MRI has a negotiated rate of $904 with one insurer's PPO plan and $1,509 with another's — identical hospital, identical scan.
Full explanation →Payer ?Payer The insurance company footing the bill — Aetna, UnitedHealthcare, Medicare, and so on. Example: "Blue Cross Blue Shield" is the payer. Its negotiated rate for an MRI might be $904, while a different payer's negotiated rate for the same scan is $1,509. Full explanation → |
Plan ?Plan The specific product an insurer sells — e.g. "Blue Cross PPO 500" — which sets your deductible, coinsurance and negotiated rates. Example: Two people both insured by Aetna can owe very different amounts for the same MRI: $50 with an HMO plan's flat copay, or the full $1,200 toward a high-deductible PPO plan's unmet deductible. Full explanation → |
Negotiated rate | vs. cash |
|---|---|---|---|
| Zing Health | Medicare Advantage | $1.10 | ↓ -100% |
| Summacare | Medicare Advantage Lower Level | $327.65 | ↓ -86% |
| Summacare | Preferred | $327.65 | ↓ -86% |
| Summacare | Medicare Advantage Psych | $356.08 | ↓ -85% |
| United | Managed Medicaid | $401.80 | ↓ -83% |
| Caresource | Managed Medicaid | $413.85 | ↓ -83% |
| Buckeye | Managed Medicaid | $421.89 | ↓ -82% |
| Summacare | Medicare Advantage CNA | $428.46 | ↓ -82% |
| AmeriHealth | Managed Medicaid | $441.98 | ↓ -81% |
| Molina | Managed Medicaid | $441.98 | ↓ -81% |
| The Health Plan | Medicare Advantage | $474.77 | ↓ -80% |
| Anthem | Medicare Advantage | $474.77 | ↓ -80% |
| Cigna | Medicare Advantage | $474.77 | ↓ -80% |
| Humana | Medicare Advantage HMO | $474.77 | ↓ -80% |
| United | Medicare Advantage | $474.77 | ↓ -80% |
| Aetna | Medicare Advantage | $474.77 | ↓ -80% |
| Summacare | Medicare Advantage MD | $478.87 | ↓ -80% |
| MMO | Medicare HMO & PPO | $489.01 | ↓ -79% |
| Summacare | Premier | $498.51 | ↓ -79% |
| CommuniCare | Medicare Advantage | $498.51 | ↓ -79% |
| Perennial Health | Medicare Advantage | $512.75 | ↓ -78% |
| The Health Plan | All Products PCP | $522.25 | ↓ -78% |
| The Health Plan | All Products Specialty Physicians | $545.99 | ↓ -77% |
| The Health Plan | All Products Radiation Oncology Physicians | $617.20 | ↓ -74% |
| Anthem | All Products Mid-Level Non-Facility | $706.63 | ↓ -70% |
| Oscar | All Products | $932.04 | ↓ -61% |
| United | All Products - Mid-Level | $1,183.62 | ↓ -50% |
| Aultcare | PPO/HMO | $1,313.14 | ↓ -45% |
| United | HMO & PPO | $1,315.14 | ↓ -45% |
| United | All Products | $1,315.14 | ↓ -45% |
| OHCP | All Products | $1,426.85 | ↓ -40% |
| OMAS | All Products | $1,834.00 | ↓ -23% |
| PHPHI | All Products | $2,200.80 | ↓ -8% |
| MMO | Traditional | $2,567.60 | ↑ +8% |
| GMS | All Products | $2,567.60 | ↑ +8% |
| Aetna | All Products First Health | $2,751.00 | ↑ +15% |
| Immergrun | All Products | $2,751.00 | ↑ +15% |
| Aetna | Asa | $2,934.40 | ↑ +23% |
| Multiplan | All Products | $3,301.20 | ↑ +38% |
| Aetna | Qhp/Ifp | $3,668.00 | ↑ +54% |
| UNITED | Managed Medicaid | $10,237.62 | ↑ +329% |
| CARESOURCE | Managed Medicaid | $10,544.75 | ↑ +342% |
| ANTHEM | Managed Medicaid | $10,749.50 | ↑ +351% |
| MOLINA | Managed Medicaid | $10,749.50 | ↑ +351% |
| The Health Plan | MEDICARE ADVANTAGE | $10,804.26 | ↑ +353% |
| AMERIHEALTH | Managed Medicaid | $11,261.38 | ↑ +372% |
| HUMANA | Medicare Advantage HMO | $12,004.74 | ↑ +404% |
| UNITED | MEDICARE ADVANTAGE | $12,004.74 | ↑ +404% |
| AETNA | MEDICARE ADVANTAGE | $12,482.03 | ↑ +424% |
| Summacare | MEDICARE ADVANTAGE | $12,482.03 | ↑ +424% |
| ANTHEM | MEDICARE ADVANTAGE | $12,482.03 | ↑ +424% |
| CIGNA | MEDICARE ADVANTAGE | $12,856.49 | ↑ +439% |
| Perennial Health | MEDICARE ADVANTAGE | $12,965.12 | ↑ +444% |
| CommuniCare | MEDICARE ADVANTAGE | $13,106.13 | ↑ +450% |
| Perennial Health | HMO I-SNP and HMO C-SNP | $13,480.59 | ↑ +465% |
| MMO | ALL PRODUCTS | $19,426.23 | ↑ +715% |
| MMO | SuperMed | $21,917.95 | ↑ +819% |
| Aetna | Acop | not published by hospital | — |
| Aetna | ALL PRODUCTS | not published by hospital | — |
| Cigna | All Products Mid-Level | not published by hospital | — |
| Cigna | All Products Physician | not published by hospital | — |
Visitor-reported prices
Comments
Insert semi-rigid prosthesis at other Ohio hospitals
| Hospital | City | Cash price | Negotiated range |
|---|---|---|---|
| cleveland clinic main campus | Cleveland | $2,384.20 | $1.10 – $14,538.24 |
| akron general | Akron | $2,384.20 | $1.10 – $12,965.12 |
| avon hospital | Avon | not published | $10,688.80 – $13,730.23 |
| cleveland clinic childrens hospital for rehabilitation | Cleveland | not published | $17,450.93 – $20,206.34 |
| euclid hospital | Euclid | not published | $10,950.94 – $13,730.23 |
| fairview hospital | Cleveland | not published | $10,287.86 – $13,730.23 |
| lutheran hospital | Cleveland | not published | $9,794.40 – $13,730.23 |
| hillcrest hospital | Mayfield Heights | not published | $10,718.35 – $13,730.23 |